There is another reason why home self-tests are important to be made available, affordable, and accessible to all. A photograph published in news in early February 2022 shows 'healthcare workers under police protection' going door to door to conduct COVID-19 testing.
Noted infectious diseases expert Dr Ishwar Gilada is right in commenting on this news that "Looking here, people have been right in doing home self-tests using rapid antigen detection tests and following self-quarantine if they were positive for COVID-19, without notifying to authorities! Who wants to be stigmatised in this way? Look at the health team without social distancing and posing [with the person being tested fully visible]."
We do not know if the health authorities and police (or media) took permission from the person, who is being tested in the photograph, to take and make the photo public, but we do know that such top-down approaches to infection control have been counterproductive for public health as well as for human rights.
Open letter calls upon WHO to issue self-testing guidelines
The open letter calls upon the WHO to expedite the finalisation and release of a self-testing guideline for SARS-CoV-2 infection that includes a strong recommendation in favour of widespread access to self-testing. It is believed that the Guideline Development Process of WHO is currently underway, due to which the open letter emphasises the urgency of WHO making an immediate statement in favour of this important tool for COVID-19 control in the interim.
Dr Ishwar Gilada, who was among the first doctors to begin HIV medical management when the first HIV infection case was diagnosed in India, said to CNS (Citizen News Service): "It is very important that home self-testing be made available to everyone. We need to empower and trust people as equal partners with dignity in the fight against COVID-19. I have not seen anyone who is 'wanting to infect others'. So this fear is unfounded. People will like to protect their families and others who they come in contact with, provided they know their COVID-19 status. We saw this approach work in rights-based health responses to control other infectious diseases."
Self-testing has the capacity of greatly expanding the number of people who know that they have contracted COVID-19 and are likely to be infectious to others. Access to self-tests promises significant benefits, particularly in resource-limited and geographically remote settings that lack sufficient RT-PCR testing capacity. Even in areas with RT-PCR testing know- how, self-testing can increase uptake among marginalised populations who are less able and/ or likely to engage with the health system because of stigma, discrimination or unaffordability.
Dr Gilada added that during the peak of Omicron wave in Maharashtra state of India, RT-PCR test results came back in 2-4 days. "What is the use of getting RT-PCR test results so late as symptoms come and go in 3 days usually. If we do not get timely reports then the person may be under a false sense of security. This will not only delay linking with clinical care pathway but also put family and others at risk of getting infected. We should make rapid antigen detection tests available for all so that people can use them to know their status, and act accordingly to prevent any further transmission, as well as link up with the health and clinical care pathways." He rightly calls for WHO and governments to strictly regulate the price of home self-tests.
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